Girl's death stirs debate over psychiatric meds

'Happy medicine'
Prosecutors say the Rileys intentionally tried to quiet their daughter with high doses of Clonidine. Relatives told police the Rileys called Clonidine the “happy medicine” and the “sleep medicine.”

Through their attorneys, Michael Riley, 34, and Carolyn Riley, 32, have accused Rebecca’s psychiatrist, Dr. Kayoko Kifuji, of over-prescribing medication.

Kifuji did not return calls for comment and declined to be interviewed. But Kifuji has vehemently denied any role in Rebecca’s death. She has agreed to a suspension of her license while the state’s medical board investigates.

Kifuji told police Rebecca had been her patient since August 2004, when she was 2. She said she based her diagnoses of ADHD and bipolar disorder on the family’s mental health history, as described by Carolyn Riley, and Rebecca’s behavior, as described by Carolyn and briefly observed by her during office visits.

Kifuji told police she became alarmed in October 2005 when Carolyn Riley told her she had increased Rebecca’s nighttime dose of Clonidine from 2 to 2½ tablets, and warned Carolyn the increased dose could kill Rebecca.

But Carolyn told investigators Kifuji told her she could give Rebecca and her sister extra Clonidine at night to help them sleep.

Tufts-New England Medical Center, where Kifuji worked, issued a statement supporting Kifuji, saying her care of Rebecca “was appropriate and within responsible professional standards.”

‘They don't look right’
In the months leading up to Rebecca’s death, others noticed there was something wrong.

Gary Higgins / AP Michael Riley, 34, and his wife, Carolyn Riley, 32, were charged in the overdosing death of their 4-year-old daughter. They pleaded not guilty.

Teachers and staff members at the Johnson Early Childhood Center in Weymouth, about 20 miles south of Boston, say they called Rebecca’s mother repeatedly to tell her that Rebecca was “out of it,” but her mother said the girl was tired because she wasn’t sleeping well.

A neighbor who lived next door to the family in the last month of Rebecca’s life said Rebecca and her siblings seemed listless.

“They looked like little robots. They looked very lethargic,” Phyllis Lipton said. “I said, ‘Wow, they don’t look right,’ but who knew?”

Pharmacists at Walgreens in Weymouth called Kifuji twice to complain that Carolyn Riley was asking for more Clonidine, even though her prescription was not due to be refilled yet, according to state police.

Once, Riley said she had lost a bottle of pills, and another time, she said water had gotten into her prescription bottle and ruined the pills, according to police.

Kifuji authorized refills, but after the second incident, she began prescribing Clonidine in 10-day refills instead of 30-day supplies, investigators said.

On Aug. 16, a prescription for 35 Clonidine tablets — a 10-day supply — was filled at Walgreens, even though the Rileys had obtained a 10-day refill only the day before, investigators said.

Walgreens spokeswoman Tiffani Bruce said: “The scrip was filled as written, as it was prescribed by the doctor, and all the appropriate information on the medications was given to the family.”

‘The doctor is God’
After Rebecca’s death, police found only seven Clonidine tablets in the family’s medicine tray; the pharmacist said there should have been 75. All together, prosecutors say, Carolyn Riley got 200 more pills in one year than she should have.

The Rileys’ lawyers call them unsophisticated people who did not question their children’s doctors.

Both were unemployed; they collected welfare and disabilty benefits and lived in subsidized housing. Michael Riley, who is also awaiting trial on charges of molesting a stepdaughter in 2005, claimed to suffer from bipolar disorder and a rage disorder; his wife told police she suffered from depression and anxiety.

“They are not the sort of people who go on the Internet and look on WebMD. These are the sort of people who, when they go to a doctor, the doctor is God and they do what the doctor says,” said John Darrell, Michael’s lawyer.

Carolyn’s lawyer, Michael Bourbeau, said that because the Rileys’ three children were all taking Clonidine, Rebecca’s prescription may have come up short at times when her siblings were given some of her pills. And some of the pills may have been lost when they were split in half, he said.

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